To start off let me say I’ve gotten several great ideas from readers of my last post. I plan to research and write on them in the coming weeks. Thank you all for participating. This post, however, is about today’s endo appointment and how it took me in a whole new direction I have never been in before.
I woke up to a blood sugar of 61. Peanut-butter and jelly sandwich for breakfast? I think I will! And a little bolus to cover the extra carbs…
Once I got to my appointment the weigh-in let me know I’ve lost six pounds. Here’s to hoping I can keep it off and keep losing. But history tells me I will just gain it back, then lose it, then gain it, then lose it…..
My blood pressure was good at 124/78, if I remember correctly. I then logged into my Diasend account on my doctor’s computer so she could review all my data (they don’t have the software to upload my brand of pump).
When the doctor came in she immediately asked me if I was OK.
“Are you sure?”
“Yeah, I’m good. I’ve been going through a deep depression, but I’m OK. You’ll see my BG’s have been real high, because of the depression.”
She began to look at the chart. “Dealing with the demands of diabetes can be real hard on you.” She asked me exactly how the depression was effecting me daily and how long it’s been going on.
I explained to her all the symptoms, sleeping a ton, no motivation or interest, neglecting my hygiene and health (especially diabetes)…
She immediately got on her scheduling page and scheduled me a behaviorist consult for immediately after this appointment. She was very concerned about me.
The rest of the appointment went fairly quick because there wasn’t much to talk about concerning my data since it was obvious the depression had screwed everything up and we need to take care of that in order to get me back in line.
“I’m going to put an order in for your labs now since you’re due, but if you want to try to work on your numbers for a couple weeks first, you can wait to do them.”
“Would it be OK to add in a test for Celiac disease?”
“We certainly can, do you have concerns?”
I explained my nausea, vomiting, and stomach aches and that I had thought they were caused by the gastroparesis, but when the stomach emptying test showed it wasn’t too bad I started wondering if something else was going on.
“I agree, it most certainly could be Celiac since Celiac is an autoimmune disorder. I have several type 1 patients who also have Celiac. ” She added the test in.
Next I asked her if I could maybe switch from Humalog to Novolog to see if the change could possibly help me to lose weight. “I know there is debate as to wether Humalog is an extra weight-gainer or not, but I just need to set my mind at ease.”
She explained that we could do a kind of little scientific study. If I first get my control back on track and then take note of my average daily use of insulin and average BG with Humalog, then I could use the Novolog for a couple months and make the comparison. (And take my weight into account as well), she will support the trial period and we can make an informed decision on permanent insulin.
The only problem here is that my insurance does not cover Novolog… so the whole idea just flew out the window.
She asked to see me back in six weeks.
After the endo appointment I went upstairs to the behaviorist consult.
The behaviorist was a very nice, chipper woman. “Dr. V is very concerned about you. She sent me an e-mail letting me know the symptoms you listed to her. Can you tell me about it?”
I gave her a quick rundown of the whole thing and that it’s been going on for about three months.
She asked me a list of questions and how often I think/feel/do or don’t do certain things. Almost all of my answers were “everyday” or “more than half the time”.
“You are in an immediate urgent crisis and we need to take immediate, aggressive action to help you.” She explained that we won’t worry about medication until I have been fully evaluated and determine if I need it or not. She did schedule me to start immediate Day Therapy which apparently is a three day a week (ALL day each day) program to treat depression and anxiety. The length of my time in this program will be determined by my personal progress.
Just the thought of this makes me extremely anxious, and I told her this.
“Well, that’s the point, we need to shake you up and pull you up!”